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Pandit K, Yuen K, Puri D, Yodkhunnatham N, Millard F, Bagrodia A. Metastasis-directed therapy in testicular cancer. Curr Opin Urol 2024; 34:281-285. [PMID: 38587028 DOI: 10.1097/mou.0000000000001176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/09/2024]
Abstract
PURPOSE OF REVIEW This review highlights the importance of addressing testicular cancer metastasizing beyond the retroperitoneum, focusing on multidisciplinary approaches and advances in treatment. RECENT FINDINGS Recent literature emphasizes on the evolving landscape of metastasis-directed therapy, including surgical interventions, chemotherapy regimens, and radiation therapy. The effectiveness of these treatments varies depending on the site of metastasis, with various approaches improving survival rates and quality of life for patients. We divide our review in an organ-specific manner and focus on chemotherapeutic, surgical, and radiation therapy approaches pertaining to each site of metastasis. SUMMARY Our review suggests the pressing need for continued research to refine and personalize treatment strategies. These efforts are important for enhancing clinical practice, ultimately leading to better outcomes for patients with metastatic testicular cancer.
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Affiliation(s)
| | | | | | | | - Frederick Millard
- Department of Medicine, UC San Diego School of Medicine, La Jolla, California, USA
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2
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Giannakou M, Antoniou A, Damianou C. Preclinical robotic device for magnetic resonance imaging guided focussed ultrasound. Int J Med Robot 2023; 19:e2466. [PMID: 36169287 PMCID: PMC10078206 DOI: 10.1002/rcs.2466] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Revised: 09/12/2022] [Accepted: 09/27/2022] [Indexed: 01/05/2023]
Abstract
BACKGROUND A robotic device featuring three motion axes was manufactured for preclinical research on focussed ultrasound (FUS). The device comprises a 2.75 MHz single element ultrasonic transducer and is guided by Magnetic Resonance Imaging (MRI). METHODS The compatibility of the device with the MRI was evaluated by estimating the influence on the signal-to-noise ratio (SNR). The efficacy of the transducer in generating ablative temperatures was evaluated in phantoms and excised porcine tissue. RESULTS System's activation in the MRI scanner reduced the SNR to an acceptable level without compromising the image quality. The transducer demonstrated efficient heating ability as proved by MR thermometry. Discrete and overlapping thermal lesions were inflicted in excised tissue. CONCLUSIONS The FUS system was proven effective for FUS thermal applications in the MRI setting. It can thus be used for multiple preclinical applications of the emerging MRI-guided FUS technology. The device can be scaled-up for human use with minor modifications.
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Affiliation(s)
| | - Anastasia Antoniou
- Department of Electrical Engineering, Computer Engineering, and Informatics, Cyprus University of Technology, Limassol, Cyprus
| | - Christakis Damianou
- Department of Electrical Engineering, Computer Engineering, and Informatics, Cyprus University of Technology, Limassol, Cyprus
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3
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Peng Y, Dai Y, Yu G, Jin P. Analysis of the type of cesarean scar pregnancy impacted on the effectiveness and safety of high intensity focused ultrasound combined with ultrasound-guided suction curettage treatment. Int J Hyperthermia 2022; 39:1449-1457. [DOI: 10.1080/02656736.2022.2107715] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Affiliation(s)
- Yan Peng
- Department of Gynecology, Affiliated Shenzhen Maternity & Child Healthcare Hospital, Southern Medical University, Shenzhen, China
| | - Yu Dai
- Department of Gynecology, Affiliated Shenzhen Maternity & Child Healthcare Hospital, Southern Medical University, Shenzhen, China
| | - Guiyuan Yu
- Department of Gynecology, Affiliated Shenzhen Maternity & Child Healthcare Hospital, Southern Medical University, Shenzhen, China
| | - Ping Jin
- Department of Gynecology, Affiliated Shenzhen Maternity & Child Healthcare Hospital, Southern Medical University, Shenzhen, China
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4
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Zhang W, Zhang L. Introduction to a special issue of the International Journal of Hyperthermia: "the status and prospects of the clinical applications of high intensity focused ultrasound". Int J Hyperthermia 2021; 38:1-4. [PMID: 34420441 DOI: 10.1080/02656736.2021.1962985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Affiliation(s)
- Wendy Zhang
- Department of Radiology, Zucker School of Medicine at Hofstra Northwell, Staten Island University Hospital, Staten Island, NY, USA
| | - Lian Zhang
- Chongqing Haifu Hospital, Chongqing, China.,State Key Laboratory of Ultrasound in Medicine and Engineering, College of Biomedical Engineering, Chongqing Medical University, Chongqing, China.,Chongqing Key Laboratory of Biomedical Engineering, Chongqing Medical University, Chongqing, China
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5
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Kawasaki M, Muramatsu S, Namba H, Izumi M, Ikeuchi M, Yaogawa S, Morio K, Ushida T. Efficacy and safety of magnetic resonance-guided focused ultrasound treatment for refractory chronic pain of medial knee osteoarthritis. Int J Hyperthermia 2021; 38:46-55. [PMID: 34420438 DOI: 10.1080/02656736.2021.1955982] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
OBJECTIVE To elucidate the efficacy and safety of MRgFUS in the treatment for refractory pain derived from medial knee OA. METHODS Twenty patients with medial knee OA eligible for total knee arthroplasty were included in this prospective, non-controlled study (UMIN000010193). MRgFUS treatment was provided at the site of most severe tenderness around the medial femorotibial joint of each patient under real-time monitoring of temperature. The goal temperature of the targeted bone surface was 55 °C. Numerical rating scale (NRS) worst pain scores, Western Ontario and McMaster Universities osteoarthritis index (WOMAC) scores, EuroQol 5 dimensions index (EQ-5D) scores and pressure pain threshold (PPT) were evaluated before treatment (baseline) and at 1 week and 1, 3, 6, and 12 months post-treatment, respectively. Complications and adverse events were also assessed clinically and radiographically. RESULTS Treatment response (a 50% or greater decrease in NRS score) was seen in 14 patients (14/19, 73.7%) at 12 months post-treatment. Mean NRS score rapidly decreased at 1 month after treatment and continued to decline through the following 12 months. At final follow-up, mean NRS score was 3.2 ± 1.9, significantly lower than at baseline (p = 0.0013). Mean WOMAC and EQ-5D scores also improved significantly from 1 month after treatment. Fifteen patients showed significant sustained increases in PPTs at the sites of most severe tenderness. No serious adverse events were observed during and after treatment. CONCLUSIONS MRgFUS treatments were effective not only for managing refractory pain, but also for improving physical functions without adverse events in elderly patients with medial knee OA.
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Affiliation(s)
- Motohiro Kawasaki
- Pain Management Center, National Hospital Organization Shikoku Medical Center for Children and Adults, Zentsuji, Japan.,Department of Orthopaedic Surgery, Kochi Medical School, Kochi University, Nankoku, Japan
| | - Shudai Muramatsu
- Department of Orthopaedic Surgery, Kochi Medical School, Kochi University, Nankoku, Japan
| | - Hirofumi Namba
- Department of Orthopaedic Surgery, Kochi Medical School, Kochi University, Nankoku, Japan
| | - Masashi Izumi
- Department of Orthopaedic Surgery, Kochi Medical School, Kochi University, Nankoku, Japan
| | - Masahiko Ikeuchi
- Department of Orthopaedic Surgery, Kochi Medical School, Kochi University, Nankoku, Japan
| | - Shin Yaogawa
- Division of Radiology, Kochi Medical School Hospital, Kochi University, Nankoku, Japan
| | - Kazuo Morio
- Division of Radiology, Kochi Sougou Rehabilitation Hospital, Kochi, Japan
| | - Takahiro Ushida
- Multidisciplinary Pain Center, Aichi Medical University, Nagakute, Japan
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6
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Kok HP, Cressman ENK, Ceelen W, Brace CL, Ivkov R, Grüll H, Ter Haar G, Wust P, Crezee J. Heating technology for malignant tumors: a review. Int J Hyperthermia 2021; 37:711-741. [PMID: 32579419 DOI: 10.1080/02656736.2020.1779357] [Citation(s) in RCA: 139] [Impact Index Per Article: 46.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
The therapeutic application of heat is very effective in cancer treatment. Both hyperthermia, i.e., heating to 39-45 °C to induce sensitization to radiotherapy and chemotherapy, and thermal ablation, where temperatures beyond 50 °C destroy tumor cells directly are frequently applied in the clinic. Achievement of an effective treatment requires high quality heating equipment, precise thermal dosimetry, and adequate quality assurance. Several types of devices, antennas and heating or power delivery systems have been proposed and developed in recent decades. These vary considerably in technique, heating depth, ability to focus, and in the size of the heating focus. Clinically used heating techniques involve electromagnetic and ultrasonic heating, hyperthermic perfusion and conductive heating. Depending on clinical objectives and available technology, thermal therapies can be subdivided into three broad categories: local, locoregional, or whole body heating. Clinically used local heating techniques include interstitial hyperthermia and ablation, high intensity focused ultrasound (HIFU), scanned focused ultrasound (SFUS), electroporation, nanoparticle heating, intraluminal heating and superficial heating. Locoregional heating techniques include phased array systems, capacitive systems and isolated perfusion. Whole body techniques focus on prevention of heat loss supplemented with energy deposition in the body, e.g., by infrared radiation. This review presents an overview of clinical hyperthermia and ablation devices used for local, locoregional, and whole body therapy. Proven and experimental clinical applications of thermal ablation and hyperthermia are listed. Methods for temperature measurement and the role of treatment planning to control treatments are discussed briefly, as well as future perspectives for heating technology for the treatment of tumors.
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Affiliation(s)
- H Petra Kok
- Department of Radiation Oncology, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Erik N K Cressman
- Department of Interventional Radiology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Wim Ceelen
- Department of GI Surgery, Ghent University Hospital, Ghent, Belgium
| | - Christopher L Brace
- Department of Radiology and Biomedical Engineering, University of Wisconsin-Madison, Madison, WI, USA
| | - Robert Ivkov
- Department of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA.,Department of Oncology, Johns Hopkins University School of Medicine, Baltimore, MD, USA.,Department of Mechanical Engineering, Whiting School of Engineering, Johns Hopkins University, Baltimore, MD, USA.,Department of Materials Science and Engineering, Whiting School of Engineering, Johns Hopkins University, Baltimore, MD, USA
| | - Holger Grüll
- Department of Diagnostic and Interventional Radiology, Faculty of Medicine, University Hospital of Cologne, University of Cologne, Cologne, Germany
| | - Gail Ter Haar
- Department of Physics, The Institute of Cancer Research, London, UK
| | - Peter Wust
- Department of Radiation Oncology, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Johannes Crezee
- Department of Radiation Oncology, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
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7
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Yuan Y, Pu D, Zhan P, Zheng Y, Ren Q, Teichmann AT. Focused Ultrasound Ablation Surgery combined with ultrasound-guided suction curettage in the treatment and management of Cesarean Scar Pregnancy. Eur J Obstet Gynecol Reprod Biol 2020; 258:168-173. [PMID: 33444810 DOI: 10.1016/j.ejogrb.2020.12.031] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Revised: 12/09/2020] [Accepted: 12/18/2020] [Indexed: 12/28/2022]
Abstract
OBJECTIVE To evaluate the feasibility, safety, and effectiveness of Focused Ultrasound Ablation Surgery (FUAS) combined with ultrasound-guided suction curettage in the management of Cesarean Scar Pregnancy (CSP). STUDY DESIGN We retrospectively analyzed 52 patients with CSP from April, 2017, to December, 2019. All the patients received one session of FUAS, and suction curettage under ultrasound guidance was performed 1-3 days after FUAS. The intraoperative blood loss in suction curettage, duration of vaginal bleeding after curettage, reproductive outcomes, and adverse effects were recorded and analyzed. RESULTS All the 52 patients completed one session of FUAS combined with suction curettage without serious adverse effects. The mean intraoperative blood loss was 32.81 ± 53.83 mL. 47 (90.38 %) patients had a successful suction curettage with a blood loss of less than 80 mL. 5 (9.62 %) patients had an active bleeding of ≥80 mL; however, the bleeding was stopped effectively by Foley's urinary catheter and no evident bleeding presented when the catheter was removed 24 h later. The mean duration of vaginal bleeding was 7.88 ± 4.24 days. 48 (92.30 %) patients recovered with little vaginal bleeding after curettage. 4 (7.69 %) type III CSP patients experienced late-onset severe bleeding and required UAE or surgery. During 6-36 months of the follow-up period, 12 patients expressed reproductive plan, in which 4 patients delivered by cesarean section, 3 patients had an ongoing pregnancy and 1 patient had an abortion in the early pregnancy. CONCLUSIONS FUAS combined with ultrasound-guided suction curettage is a safe and effective treatment strategy in the management of CSP type I and CSP type II and is particularly advantageous for CSP patients with reproductive requirements. However, further studies are warranted to determine the meticulous inclusion criteria for patients with type III CSP.
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Affiliation(s)
- Yuan Yuan
- Sichuan Provincial Center for Gynaecology and Breast Diseases, The Affiliated Hospital of Southwest Medical University, No.25 Taiping Street, Luzhou, Sichuan, 644300, China; State Key Laboratory of Ultrasound in Medicine and Engineering, Chongqing Medical University, Chongqing, 400016, China
| | - Dali Pu
- Sichuan Provincial Center for Gynaecology and Breast Diseases, The Affiliated Hospital of Southwest Medical University, No.25 Taiping Street, Luzhou, Sichuan, 644300, China
| | - Ping Zhan
- Sichuan Provincial Center for Gynaecology and Breast Diseases, The Affiliated Hospital of Southwest Medical University, No.25 Taiping Street, Luzhou, Sichuan, 644300, China
| | - Yongping Zheng
- Sichuan Provincial Center for Gynaecology and Breast Diseases, The Affiliated Hospital of Southwest Medical University, No.25 Taiping Street, Luzhou, Sichuan, 644300, China
| | - Qianchuan Ren
- Sichuan Provincial Center for Gynaecology and Breast Diseases, The Affiliated Hospital of Southwest Medical University, No.25 Taiping Street, Luzhou, Sichuan, 644300, China
| | - Alexander T Teichmann
- Sichuan Provincial Center for Gynaecology and Breast Diseases, The Affiliated Hospital of Southwest Medical University, No.25 Taiping Street, Luzhou, Sichuan, 644300, China.
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Filippiadis DK, Tselikas L, Bazzocchi A, Efthymiou E, Kelekis A, Yevich S. Percutaneous Management of Cancer Pain. Curr Oncol Rep 2020; 22:43. [DOI: 10.1007/s11912-020-00906-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
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9
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Arrigoni F, Bruno F, Palumbo P, Zugaro L, Zoccali C, Barile A, Masciocchi C. Magnetic resonance-guided focused ultrasound surgery treatment of non-spinal intra-articular osteoblastoma: feasibility, safety, and outcomes in a single-center retrospective analysis. Int J Hyperthermia 2019; 36:768-775. [DOI: 10.1080/02656736.2019.1639833] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
Affiliation(s)
- Francesco Arrigoni
- Department of Emergency and Interventional Radiology, San Salvatore Hospital, L'Aquila, Italy
| | - Federico Bruno
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
| | - Pierpaolo Palumbo
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
| | - Luigi Zugaro
- Department of Emergency and Interventional Radiology, San Salvatore Hospital, L'Aquila, Italy
| | - Carmine Zoccali
- Department of Oncological Orthopaedics, Muscular-skeletal Tissue Bank, IFO-Regina Elena National Cancer Institute, Rome, Italy
| | - Antonio Barile
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
| | - Carlo Masciocchi
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
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10
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Focused Ultrasound Effects on Osteosarcoma Cell Lines. BIOMED RESEARCH INTERNATIONAL 2019; 2019:6082304. [PMID: 31236409 PMCID: PMC6545756 DOI: 10.1155/2019/6082304] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/19/2018] [Accepted: 04/09/2019] [Indexed: 12/13/2022]
Abstract
MRI guided Focused Ultrasound (MRgFUS) has shown to be effective therapeutic modality for non-invasive clinical interventions in ablating of uterine fibroids, in bone metastasis palliative treatments, and in breast, liver, and prostate cancer ablation. MRgFUS combines high intensity focused ultrasound (HIFU) with MRI images for treatment planning and real time thermometry monitoring, thus enabling non-invasive ablation of tumor tissue. Although in the literature there are several studies on the Ultrasound (US) effects on cell in culture, there is no systematic evidence of the biological effect of Magnetic Resonance guided Focused Ultrasound Surgery (MRgFUS) treatment on osteosarcoma cells, especially in lower dose regions, where tissues receive sub-lethal acoustic power. The effect of MRgFUS treatment at different levels of acoustic intensity (15.5-49 W/cm2) was investigated on Mg-63 and Saos-2 cell lines to evaluate the impact of the dissipation of acoustic energy delivered outside the focal area, in terms of cell viability and osteogenic differentiation at 24 h, 7 days, and 14 days after treatment. Results suggested that the attenuation of FUS acoustic intensities from the focal area (higher intensities) to the “far field” (lower intensities) zones might determine different osteosarcoma cell responses, which range from decrease of cell proliferation rates (from 49 W/cm2 to 38.9 W/cm2) to the selection of a subpopulation of heterogeneous and immature living cells (from 31.1 W/cm2 to 15.5 W/cm2), which can clearly preserve bone tumor cells.
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11
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Errani C, Bazzocchi A, Spinnato P, Facchini G, Campanacci L, Rossi G, Mavrogenis AF. What’s new in management of bone metastases? EUROPEAN JOURNAL OF ORTHOPAEDIC SURGERY AND TRAUMATOLOGY 2019; 29:1367-1375. [DOI: 10.1007/s00590-019-02446-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/27/2019] [Accepted: 05/03/2019] [Indexed: 12/18/2022]
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12
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Zhu X, Chen L, Deng X, Xiao S, Ye M, Xue M. A comparison between high-intensity focused ultrasound and surgical treatment for the management of abdominal wall endometriosis. BJOG 2019; 124 Suppl 3:53-58. [PMID: 28856859 DOI: 10.1111/1471-0528.14737] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/06/2017] [Indexed: 12/13/2022]
Abstract
OBJECTIVE The aim of this study was to compare the therapeutic outcomes of high-intensity focused ultrasound (HIFU) and surgical treatment for abdominal wall endometriosis. DESIGN A retrospective study. SETTING Gynaecological department of a teaching hospital in China. POPULATION Patients with abdominal wall endometriosis. METHODS Among the 51 patients, 23 patients were treated with ultrasound-guided HIFU and 28 patients with surgery. Pain relief and the size change of the nodule after each management were evaluated 1, 3, 6 and 12 months after treatment, respectively. The hospital stay and blood loss were also compared. MAIN OUTCOME MEASURES Difference between HIFU and surgical treatment for abdominal wall endometriosis. RESULTS No statistically significant differences were observed between the two groups in the pain relief in 1, 3, 6 and 12 months after treatment, respectively. The hospital stay was clearly shorter in the HIFU group than in the surgery group. Change in nodules was more remarkable in the group treated with surgery; no palpable nodules existed in most patients in the surgery group. HIFU had more advantages over surgery, such as no blood loss, no new scar, no anaesthesia and lower pain score immediately after treatment. CONCLUSIONS Based on our results, it appears that either HIFU or surgery is safe and effective in treating patients with AWE in short-term. Compared with surgery, HIFU treatment for AWE has the advantages of shorter hospital stay, no blood loss, no new scar, no anaesthesia and a lower immediate pain score. TWEETABLE ABSTRACT Either HIFU or surgical treatment is safe and effective in treating patients with AWE. HIFU has the advantages of a less invasive procedure and shorter hospital stay.
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Affiliation(s)
- X Zhu
- Department of Gynaecology, Third Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - L Chen
- Department of Gynaecology, Third Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - X Deng
- Department of Gynaecology, Third Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - S Xiao
- Department of Gynaecology, Third Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - M Ye
- Department of Gynaecology, Third Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - M Xue
- Department of Gynaecology, Third Xiangya Hospital of Central South University, Changsha, Hunan, China
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MR Imaging of Pediatric Musculoskeletal Tumors:: Recent Advances and Clinical Applications. Magn Reson Imaging Clin N Am 2019; 27:341-371. [PMID: 30910102 DOI: 10.1016/j.mric.2019.01.010] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Pediatric musculoskeletal tumors comprise approximately 10% of childhood neoplasms, and MR imaging has been used as the imaging evaluation standard for these tumors. The role of MR imaging in these cases includes identification of tumor origin, tissue characterization, and definition of tumor extent and relationship to adjacent structures as well as therapeutic response in posttreatment surveillance. Technical advances have enabled quantitative evaluation of biochemical changes in tumors. This article reviews recent updates to MR imaging of pediatric musculoskeletal tumors, focusing on advanced MR imaging techniques and providing information on the relevant physics of these techniques, clinical applications, and pitfalls.
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Adams C, Carpenter TM, Cowell D, Freear S, McLaughlan JR. HIFU Drive System Miniaturization Using Harmonic Reduced Pulsewidth Modulation. IEEE TRANSACTIONS ON ULTRASONICS, FERROELECTRICS, AND FREQUENCY CONTROL 2018; 65:2407-2417. [PMID: 30371363 PMCID: PMC6305628 DOI: 10.1109/tuffc.2018.2878464] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/01/2018] [Accepted: 10/24/2018] [Indexed: 05/30/2023]
Abstract
Switched excitation has the potential to improve on the cost, efficiency, and size of the linear amplifier circuitry currently used in high-intensity focused ultrasound (HIFU) systems. Existing switching schemes are impaired by high harmonic distortion or lack array apodisation capability, so require adjustable supplies and/or large power filters to be useful. A multilevel pulsewidth modulation (PWM) topology could address both of these issues but the switching-speed limitations of transistors mean that there are a limited number of pulses available in each waveform cycle. In this study, harmonic reduction PWM (HRPWM) is proposed as an algorithmic solution to the design of switched waveforms. Its appropriateness for HIFU was assessed by design of a high power five-level unfiltered amplifier and subsequent thermal-only lesioning of ex vivo chicken breast. Three switched waveforms of different electrical powers (16, 26, 35 W) were generated using the HRPWM algorithm. Lesion sizes were measured and compared with those made at the same electrical power using a linear amplifier and bi-level excitation. HRPWM produced symmetric, thermal-only lesions that were the same size as their linear amplifier equivalents ( ). At 16 W, bi-level excitation produced smaller lesions but at higher power levels large transients in the acoustic waveform nucleated undesired cavitation. These results demonstrate that HRPWM can minimize HIFU drive circuity size without the need for filters to remove harmonics or adjustable power supplies to achieve array apodisation.
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15
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McLaughlan JR. Controllable Nucleation of Cavitation from Plasmonic Gold Nanoparticles for Enhancing High Intensity Focused Ultrasound Applications. J Vis Exp 2018. [PMID: 30346394 PMCID: PMC6235418 DOI: 10.3791/58045] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
In this study, plasmonic gold nanoparticles were simultaneously exposed to pulsed near-infrared laser light and high intensity focused ultrasound (HIFU) for the controllable nucleation of cavitation in tissue-mimicking gel phantoms. This in vitro protocol was developed to demonstrate the feasibility of this approach, for both enhancement of imaging and therapeutic applications for cancer. The same apparatus can be used for both imaging and therapeutic applications by varying the exposure duration of the HIFU system. For short duration exposures (10 µs), broadband acoustic emissions were generated through the controlled nucleation of inertial cavitation around the gold nanoparticles. These emissions provide direct localization of nanoparticles. For future applications, these particles may be functionalized with molecular-targeting antibodies (e.g. anti-HER2 for breast cancer) and can provide precise localization of cancerous regions, complementing routine diagnostic ultrasound imaging. For continuous wave (CW) exposures, the cavitation activity was used to increase the localized heating from the HIFU exposures resulting in larger thermal damage in the gel phantoms. The acoustic emissions generated from inertial cavitation activity during these CW exposures was monitored using a passive cavitation detection (PCD) system to provide feedback of cavitation activity. Increased localized heating was only achieved through the unique combination of nanoparticles, laser light and HIFU. Further validation of this technique in pre-clinical models of cancer is necessary.
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Affiliation(s)
- James R McLaughlan
- School of Electronic and Electrical Engineering, University of Leeds; Leeds Institute of Cancer and Pathology, University of Leeds;
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16
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Bobola MS, Chen L, Ezeokeke CK, Kuznetsova K, Lahti AC, Lou W, Myroniv AN, Schimek NW, Selby ML, Mourad PD. A Review of Recent Advances in Ultrasound, Placed in the Context of Pain Diagnosis and Treatment. Curr Pain Headache Rep 2018; 22:60. [PMID: 29987680 PMCID: PMC6061208 DOI: 10.1007/s11916-018-0711-7] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Ultrasound plays a significant role in the diagnosis and treatment of pain, with significant literature reaching back many years, especially with regard to diagnostic ultrasound and its use for guiding needle-based delivery of drugs. Advances in ultrasound over at least the last decade have opened up new areas of inquiry and potential clinical efficacy in the context of pain diagnosis and treatment. Here we offer an overview of the recent literature associated with ultrasound and pain in order to highlight some promising frontiers at the intersection of these two subjects. We focus first on peripheral application of ultrasound, for which there is a relatively rich, though still young, literature. We then move to central application of ultrasound, for which there is little literature but much promise.
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Affiliation(s)
- Michael S Bobola
- Department of Neurological Surgery, University of Washington, Seattle, WA, USA
| | - Lucas Chen
- Department of Neurological Surgery, University of Washington, Seattle, WA, USA
| | | | - Katy Kuznetsova
- Applied Physics Laboratory, University of Washington, Seattle, WA, USA
| | - Annamarie C Lahti
- Department of Neurological Surgery, University of Washington, Seattle, WA, USA
| | - Weicheng Lou
- Department of Neurological Surgery, University of Washington, Seattle, WA, USA
| | - Aleksey N Myroniv
- Department of Neurological Surgery, University of Washington, Seattle, WA, USA
| | - Nels W Schimek
- Department of Neurological Surgery, University of Washington, Seattle, WA, USA
| | - Madison L Selby
- Department of Neurological Surgery, University of Washington, Seattle, WA, USA
| | - Pierre D Mourad
- Department of Neurological Surgery, University of Washington, Seattle, WA, USA.
- Applied Physics Laboratory, University of Washington, Seattle, WA, USA.
- Division of Engineering and Mathematics, University of Washington, Bothell, WA, USA.
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Elhelf IS, Albahar H, Shah U, Oto A, Cressman E, Almekkawy M. High intensity focused ultrasound: The fundamentals, clinical applications and research trends. Diagn Interv Imaging 2018; 99:349-359. [DOI: 10.1016/j.diii.2018.03.001] [Citation(s) in RCA: 83] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2018] [Revised: 02/22/2018] [Accepted: 03/06/2018] [Indexed: 02/06/2023]
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Dababou S, Marrocchio C, Scipione R, Erasmus HP, Ghanouni P, Anzidei M, Catalano C, Napoli A. High-Intensity Focused Ultrasound for Pain Management in Patients with Cancer. Radiographics 2018; 38:603-623. [PMID: 29394144 DOI: 10.1148/rg.2018170129] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Cancer-related pain affects up to 80% of patients with malignancies. Pain is an important distressing symptom that diminishes the quality of life and negatively affects the survival of patients. Opioid analgesics are generally the primary therapy for cancer-related pain, with surgery, radiation therapy, chemotherapy, and other interventions used in cases of treatment-resistant pain. These treatments, which can be associated with substantial side effects and systemic toxicity, may not be effective. High-intensity focused ultrasound is an entirely noninvasive technique that is approved for treatment of uterine fibroids, bone metastases, and essential tremors. With magnetic resonance imaging or ultrasonographic guidance, high-intensity ultrasound waves are focused on a small well-demarcated region to result in precise localized ablation. This treatment may represent a multimodality approach to treating patients with malignant diseases-facilitating pain palliation, enhanced local drug delivery and radiation therapy effects, and stimulation of anticancer specific immune responses, and potentially facilitating local tumor control. Focused ultrasound can be used to achieve pain palliation by producing several effects, including tissue denervation, tumor mass reduction, and neuromodulation, that can influence different pathways at the origin of the pain. This technology has several key advantages compared with other analgesic therapies: It is completely noninvasive, might be used to achieve rapid pain control, can be safely repeated, and can be used in combination with chemotherapy and radiation therapy to enhance their effects. Online supplemental material is available for this article. ©RSNA, 2018.
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Affiliation(s)
- Susan Dababou
- From the Department of Radiological Sciences, Sapienza University of Rome, School of Medicine, V.le Regina Elena 324, 00180 Rome, Italy (S.D., C.M., R.S., H.P.E., M.A., C.C., A.N.); and Department of Radiology, Stanford University School of Medicine, Stanford, Calif (P.G.)
| | - Cristina Marrocchio
- From the Department of Radiological Sciences, Sapienza University of Rome, School of Medicine, V.le Regina Elena 324, 00180 Rome, Italy (S.D., C.M., R.S., H.P.E., M.A., C.C., A.N.); and Department of Radiology, Stanford University School of Medicine, Stanford, Calif (P.G.)
| | - Roberto Scipione
- From the Department of Radiological Sciences, Sapienza University of Rome, School of Medicine, V.le Regina Elena 324, 00180 Rome, Italy (S.D., C.M., R.S., H.P.E., M.A., C.C., A.N.); and Department of Radiology, Stanford University School of Medicine, Stanford, Calif (P.G.)
| | - Hans-Peter Erasmus
- From the Department of Radiological Sciences, Sapienza University of Rome, School of Medicine, V.le Regina Elena 324, 00180 Rome, Italy (S.D., C.M., R.S., H.P.E., M.A., C.C., A.N.); and Department of Radiology, Stanford University School of Medicine, Stanford, Calif (P.G.)
| | - Pejman Ghanouni
- From the Department of Radiological Sciences, Sapienza University of Rome, School of Medicine, V.le Regina Elena 324, 00180 Rome, Italy (S.D., C.M., R.S., H.P.E., M.A., C.C., A.N.); and Department of Radiology, Stanford University School of Medicine, Stanford, Calif (P.G.)
| | - Michele Anzidei
- From the Department of Radiological Sciences, Sapienza University of Rome, School of Medicine, V.le Regina Elena 324, 00180 Rome, Italy (S.D., C.M., R.S., H.P.E., M.A., C.C., A.N.); and Department of Radiology, Stanford University School of Medicine, Stanford, Calif (P.G.)
| | - Carlo Catalano
- From the Department of Radiological Sciences, Sapienza University of Rome, School of Medicine, V.le Regina Elena 324, 00180 Rome, Italy (S.D., C.M., R.S., H.P.E., M.A., C.C., A.N.); and Department of Radiology, Stanford University School of Medicine, Stanford, Calif (P.G.)
| | - Alessandro Napoli
- From the Department of Radiological Sciences, Sapienza University of Rome, School of Medicine, V.le Regina Elena 324, 00180 Rome, Italy (S.D., C.M., R.S., H.P.E., M.A., C.C., A.N.); and Department of Radiology, Stanford University School of Medicine, Stanford, Calif (P.G.)
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McLaughlan JR, Cowell DMJ, Freear S. Gold nanoparticle nucleated cavitation for enhanced high intensity focused ultrasound therapy. Phys Med Biol 2017; 63:015004. [PMID: 29098986 DOI: 10.1088/1361-6560/aa97e9] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
High intensity focused ultrasound (HIFU) or focused ultrasound surgery is a non-invasive technique for the treatment of cancerous tissue, which is limited by difficulties in getting real-time feedback on treatment progress and long treatment durations. The formation and activity of acoustic cavitation, specifically inertial cavitation, during HIFU exposures has been demonstrated to enhance heating rates. However, without the introduction of external nuclei its formation an activity can be unpredictable, and potentially counter-productive. In this study, a combination of pulse laser illumination (839 nm), HIFU exposures (3.3 MHz) and plasmonic gold nanorods (AuNR) was demonstrated as a new approach for the guidance and enhancement of HIFU treatments. For imaging, short duration HIFU pulses (10 μs) demonstrated broadband acoustic emissions from AuNR nucleated cavitation with a signal-to-noise ranging from 5-35 dB for peak negative pressures between 1.19-3.19 ± 0.01 MPa. In the absence of either AuNR or laser illumination these emissions were either not present or lower in magnitude (e.g. 5 dB for 3.19 MPa). Continuous wave (CW) HIFU exposures for 15 s, were then used to generate thermal lesions for peak negative pressures from 0.2-2.71 ± 0.01 MPa at a fluence of 3.4 mJ [Formula: see text]. Inertial cavitation dose (ICD) was monitored during all CW exposures, where exposures combined with both laser illumination and AuNRs resulted in the highest level of detectable emissions. This parameter was integrated over the entire exposure to give a metric to compare with measured thermal lesion area, where it was found that a minimum total ICD of [Formula: see text] a.u. was correlated with the formation of thermal lesions in gel phantoms. Furthermore, lesion area (mm2) was increased for equivalent exposures without either AuNRs or laser illumination. Once combined with cancer targeting AuNRs this approach could allow for the future theranostic use of HIFU, such as providing the ability to identify and treat small multi-focal cancerous regions with minimal damage to surrounding healthy tissue.
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Affiliation(s)
- J R McLaughlan
- School of Electronic and Electrical Engineering, University of Leeds, Leeds, LS2 9JT, United Kingdom. Leeds Institute of Cancer and Pathology, University of Leeds, Leeds, LS9 7TF, United Kingdom
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Abstract
OPINION STATEMENT Percutaneous thermal ablation, including microwave ablation (MWA), radiofrequency ablation (RFA), and cryoablation, is a well-established focal treatment option for primary and metastatic malignancies. While published literature specific to ablation of sarcomas is relatively lacking compared with non-sarcomatous malignancies, what is available is promising. In situations where a focal treatment option is desired, strong consideration should be given to percutaneous thermal ablation, in addition to surgery and radiation therapy. A significant advantage of percutaneous thermal ablation over surgery and radiation includes the repeatability of ablation, as there is no absolute limit on the number of times an ablation can be performed. Compared with surgery, ablation offers the potential of decreased recovery time, a less invasive procedure, and is often performed in patients deemed not medically fit for surgery.
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Pezzuto A, Morrone M, Mici E. Unusual jaw metastasis from squamous cell lung cancer in heavy smoker: Two case reports and review of the literature. Medicine (Baltimore) 2017; 96:e6987. [PMID: 28538407 PMCID: PMC5457887 DOI: 10.1097/md.0000000000006987] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
RATIONALE Jaw metastasis is a very rare condition associated with lung cancer evolution. In this paper we present two cases of patients who underwent different approach.Lung cancer is the leading cause of cancer related death worldwide. Survival depends on the staging and biology of tumor. Smoking may affect the prognosis. PATIENT CONCERNS There are herein reported the cases of two patients affected by squamous cell lung cancer with spread to mandibular bone. DIAGNOSES In the first case a computed tomography (CT scan) showed a large mass located in upper right lung , then bronchoscopy was performed with biopsies and the histology revealed a squamous cell carcinoma P63+ and TTF-. In the second case upper right lung mass with metastases to mediastinal bilateral lymph nodes was found at CT scan. A bronchial biopsy revealed a squamous cell carcinoma p63 positive and TTF-1 negative. INTERVENTIONS The first, a 65-years old man, current heavy smoker who quit and relapsed, at initial stage of IIa (T2aN1M0), after initial neo-adjuvant chemotherapy underwent lung lobectomy and lymph nodes resection. Three months later a metastasis located on mandibular bone was found out. The second case, a 68-years old female heavy smoker, at initial stage IIIb not available for surgery because of involvement of bilateral lymph nodes, underwent first line course chemotherapy with cisplatin and vinorelbine and second line with erlotinib. OUTCOMES The first patient underwent hyperthermia and radiotherapy but a sepsis developed and patients died. In the second case, after two months from the beginning of II line the patient developed a jaw metastasis and underwent surgery with resection of hemi-mandible, but soon after she died because of pulmonary embolism. LESSONS These cases highlight the poor prognosis of patients current smokers affected by squamous cell lung cancer. The jaw bone localization is very rare and different approach could be applied.
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Affiliation(s)
- Aldo Pezzuto
- Department of Cardiopulmonary and Vascular Science, Sant’Andrea Hospital-Sapienza University Rome, PhD Medical Bio-Science Campus
| | - Michelangelo Morrone
- Unit of Physical and Rehabilitation Medicine, Department of Medicine, Campus Bio-Medico University
| | - Elidon Mici
- Maxillo-facial Unit, Surgery Department, S. Andrea Hospital-Sapienza University, Rome, Italy
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Minimally invasive techniques for pain palliation in extraspinal bone metastases: a review of magnetic resonance imaging-guided focused ultrasound (MRgFUS) and series conclusion. CURRENT ORTHOPAEDIC PRACTICE 2017. [DOI: 10.1097/bco.0000000000000488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Shim J, Staruch R, Koral K, Xie XJ, Chopra R, Laetsch TW. Pediatric Sarcomas Are Targetable by MR-Guided High Intensity Focused Ultrasound (MR-HIFU): Anatomical Distribution and Radiological Characteristics. Pediatr Blood Cancer 2016; 63:1753-60. [PMID: 27199087 PMCID: PMC6016837 DOI: 10.1002/pbc.26079] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2016] [Revised: 05/01/2016] [Accepted: 05/03/2016] [Indexed: 12/28/2022]
Abstract
BACKGROUND Despite intensive therapy, children with metastatic and recurrent sarcoma or neuroblastoma have a poor prognosis. Magnetic resonance guided high intensity focused ultrasound (MR-HIFU) is a noninvasive technique allowing the delivery of targeted ultrasound energy under MR imaging guidance. MR-HIFU may be used to ablate tumors without ionizing radiation or target chemotherapy using hyperthermia. Here, we evaluated the anatomic locations of tumors to assess the technical feasibility of MR-HIFU therapy for children with solid tumors. PROCEDURE Patients with sarcoma or neuroblastoma with available cross-sectional imaging were studied. Tumors were classified based on the location and surrounding structures within the ultrasound beam path as (i) not targetable, (ii) completely or partially targetable with the currently available MR-HIFU system, and (iii) potentially targetable if a respiratory motion compensation technique was used. RESULTS Of the 121 patients with sarcoma and 61 patients with neuroblastoma, 64% and 25% of primary tumors were targetable at diagnosis, respectively. Less than 20% of metastases at diagnosis or relapse were targetable for both sarcoma and neuroblastoma. Most targetable lesions were located in extremities or in the pelvis. Respiratory motion compensation may increase the percentage of targetable tumors by 4% for sarcomas and 10% for neuroblastoma. CONCLUSIONS Many pediatric sarcomas are localized at diagnosis and are targetable by current MR-HIFU technology. Some children with neuroblastoma have bony tumors targetable by MR-HIFU at relapse, but few newly diagnosed children with neuroblastoma have tumors amenable to MR-HIFU therapy. Clinical trials of MR-HIFU should focus on patients with anatomically targetable tumors.
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Affiliation(s)
- Jenny Shim
- Department of Pediatrics, Children’s Health, Dallas, Texas, USA
| | - Robert Staruch
- Department of Radiology, University of Texas Southwestern Medical Center, Dallas, Texas, USA,Philips Research North America, Cambridge, Massachusetts, USA
| | - Korgun Koral
- Department of Radiology, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Xian-Jin Xie
- Department of Clinical Sciences, Simmons Comprehensive Cancer Center, Dallas, Texas, USA
| | - Rajiv Chopra
- Department of Radiology, University of Texas Southwestern Medical Center, Dallas, Texas, USA,Advanced Imaging Research Center, University of Texas Southwestern Medical Center, Texas, USA
| | - Theodore W. Laetsch
- Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, Texas, USA,Pauline Allen Gill Center for Cancer and Blood Disorders, Children’s Health, Dallas, Texas, USA
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Menikou G, Yiannakou M, Yiallouras C, Ioannides C, Damianou C. MRI-compatible bone phantom for evaluating ultrasonic thermal exposures. ULTRASONICS 2016; 71:12-19. [PMID: 27261569 DOI: 10.1016/j.ultras.2016.05.020] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/13/2015] [Revised: 05/15/2016] [Accepted: 05/24/2016] [Indexed: 06/05/2023]
Abstract
OBJECTIVE The goal of the proposed study was the development of a magnetic resonance imaging (MRI) compatible bone phantom suitable for evaluating focused ultrasound protocols. MATERIALS AND METHODS High resolution CT images were used to segment femur bone. The segmented model was manufactured with (Acrylonitrile Butadiene Styrene) ABS plastic using a 3-D printer. The surrounding skeletal muscle tissue was mimicked using an agar-silica-evaporated milk gel (2% w/v-2% w/v-40% v/v). MR thermometry was used to evaluate the exposures of the bone phantom to focused ultrasound. RESULTS The estimated agar-silica-evaporated milk gel's T1 and T2 relaxation times in a 1.5T magnetic field were 776ms and 66ms respectively. MR thermometry maps indicated increased temperature adjacent to the bone, which was also shown in situations of real bone/tissue interfaces. CONCLUSION Due to growing interest of using MRI guided Focused Ultrasound Surgery (MRgFUS) in palliating bone cancer patients at terminal stages of the disease, the proposed bone phantom can be utilized as a very useful tool for evaluating ultrasonic protocols, thus minimizing the need for animal models. The estimated temperature measured and its distribution near the bone phantom/agar interface which was similar to temperatures recorded in real bone ablation with FUS, confirmed the phantom's functionality.
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Affiliation(s)
| | | | - Christos Yiallouras
- Cyprus University of Technology, Limassol, Cyprus; MEDSONIC LTD, Limassol, Cyprus
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Kaye EA, Monette S, Srimathveeravalli G, Maybody M, Solomon SB, Gulati A. MRI-guided focused ultrasound ablation of lumbar medial branch nerve: Feasibility and safety study in a swine model. Int J Hyperthermia 2016; 32:786-94. [PMID: 27443328 DOI: 10.1080/02656736.2016.1197972] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
PURPOSE About 10-40% of chronic low back pain cases involve facet joints, which are commonly treated with lumbar medial branch (MB) radiofrequency neurotomy. Magnetic resonance imaging-guided focused ultrasound (MRgFUS), a non-invasive, non-ionising ablation modality used to treat tumours, neuropathic pain and painful bone metastasis can also be used to disrupt nerve conduction. This work's purpose was to study the feasibility and safety of direct MRgFUS ablation of the lumbar MB nerve in acute and subacute swine models. MATERIALS AND METHODS In vivo MRgFUS ablation was performed in six swine (three acute and three subacute) using a clinical MRgFUS system and a 3-T MRI scanner combination. Behavioural assessment was performed, and imaging and histology were used to assess the treatment. RESULTS AND CONCLUSIONS Histological analysis of the in vivo studies confirmed thermal necrosis of the MB nerve could be achieved without damaging the spinal cord or adjacent nerve roots. MRgFUS did not cause changes in the animals' behaviour or ambulation.
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Affiliation(s)
- Elena A Kaye
- a Department of Medical Physics , Memorial Sloan Kettering Cancer Center , New York
| | - Sebastien Monette
- b Tri-Institutional Laboratory of Comparative Pathology, Memorial Sloan Kettering Cancer Center , Rockefeller University, Weill Cornell Medical College , New York
| | | | - Majid Maybody
- c Department of Radiology , Memorial Sloan Kettering Cancer Center , New York
| | - Stephen B Solomon
- c Department of Radiology , Memorial Sloan Kettering Cancer Center , New York
| | - Amitabh Gulati
- d Department of Anesthesiology , Memorial Sloan Kettering Cancer Center , New York , USA
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Menikou G, Yiallouras C, Yiannakou M, Damianou C. MRI-guided focused ultrasound robotic system for the treatment of bone cancer. Int J Med Robot 2016; 13. [DOI: 10.1002/rcs.1753] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2015] [Revised: 04/28/2016] [Accepted: 04/28/2016] [Indexed: 12/12/2022]
Affiliation(s)
| | - Christos Yiallouras
- Cyprus University of Technology; Limassol Cyprus
- Medsonic Ltd; Limassol Cyprus
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Lee J, Farha G, Poon I, Karam I, Higgins K, Pichardo S, Hynynen K, Enepekides D. Magnetic resonance-guided high-intensity focused ultrasound combined with radiotherapy for palliation of head and neck cancer-a pilot study. J Ther Ultrasound 2016; 4:12. [PMID: 27042308 PMCID: PMC4818916 DOI: 10.1186/s40349-016-0055-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2015] [Accepted: 03/17/2016] [Indexed: 12/17/2022] Open
Abstract
Background Radiotherapy is a critical component of the multidisciplinary management of cancers of the head and neck. It may comprise the primary curative treatment modality or is used in an adjuvant setting to improve local control and survival by preventing seeding and reseeding of distant metastases from persistent reservoirs of locoregional disease. Although considerable advances have been made recently in the fields of radiotherapy, systemic treatment and surgery for head and neck tumours, locoregional recurrence rates remain high and treatment side effects may have severe impact on patients’ quality of life. Magnetic resonance-guided high-intensity focused ultrasound (MRg-HIFU) is a novel technique in the treatment of cancer that has the potential to improve tumour cure rates and decrease treatment-related toxicity. Clinical applications of HIFU are being used increasingly for the treatment of several tumour sites, for example uterine leiomyomas and prostate cancer. Methods/Design The pilot study presented here is an initial step toward utilizing MRg-HIFU for head and neck cancer treatment. The rationale for novel treatment options in head and neck cancer is reviewed as well as emerging evidence that support the increasing clinical utilization of MRg-HIFU. Discussion This pilot study aims to assess safety, toxicity and feasibility of MRg-HIFU treatments to the head and neck region and to evaluate changes caused by MRg-HIFU within the treated tumour regions based on post-treatment MRI.
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Affiliation(s)
- Justin Lee
- Sunnybrook Health Sciences Centre, Department of Radiation Oncology, University of Toronto, Toronto, Canada
| | - Georges Farha
- Sunnybrook Health Sciences Centre, Department of Radiation Oncology, University of Toronto, Toronto, Canada
| | - Ian Poon
- Sunnybrook Health Sciences Centre, Department of Radiation Oncology, University of Toronto, Toronto, Canada
| | - Irene Karam
- Sunnybrook Health Sciences Centre, Department of Radiation Oncology, University of Toronto, Toronto, Canada
| | - Kevin Higgins
- Sunnybrook Health Sciences Centre, Department of Head and Neck Surgery, University of Toronto, Toronto, Canada
| | - Samuel Pichardo
- Thunder Bay Regional Research Institute, Department of Physics, Lakehead University, Thunder Bay, Canada
| | - Kullervo Hynynen
- Sunnybrook Health Sciences Centre, Department of Medical Physics, University of Toronto, Toronto, Canada
| | - Danny Enepekides
- Sunnybrook Health Sciences Centre, Department of Radiation Oncology, University of Toronto, Toronto, Canada
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Zhu X, Deng X, Xiao S, Wan Y, Xue M. A comparison of high-intensity focused ultrasound and uterine artery embolisation for the management of caesarean scar pregnancy. Int J Hyperthermia 2015; 32:144-50. [DOI: 10.3109/02656736.2015.1104733] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Bazzocchi A, Napoli A, Sacconi B, Battista G, Guglielmi G, Catalano C, Albisinni U. MRI-guided focused ultrasound surgery in musculoskeletal diseases: the hot topics. Br J Radiol 2015; 89:20150358. [PMID: 26607640 DOI: 10.1259/bjr.20150358] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
MRI-guided focused ultrasound surgery (MRgFUS) is a minimally invasive treatment guided by the most sophisticated imaging tool available in today's clinical practice. Both the imaging and therapeutic sides of the equipment are based on non-ionizing energy. This technique is a very promising option as potential treatment for several pathologies, including musculoskeletal (MSK) disorders. Apart from clinical applications, MRgFUS technology is the result of long, heavy and cumulative efforts exploring the effects of ultrasound on biological tissues and function, the generation of focused ultrasound and treatment monitoring by MRI. The aim of this article is to give an updated overview on a "new" interventional technique and on its applications for MSK and allied sciences.
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Affiliation(s)
- Alberto Bazzocchi
- 1 Diagnostic and Interventional Radiology, The "Rizzoli" Orthopaedic Institute, Bologna, Italy
| | - Alessandro Napoli
- 2 Department of Radiology, Sapienza University of Rome, Umberto I Hospital, Rome, Italy
| | - Beatrice Sacconi
- 2 Department of Radiology, Sapienza University of Rome, Umberto I Hospital, Rome, Italy
| | - Giuseppe Battista
- 3 Department of Specialized, Diagnostic, and Experimental Medicine, University of Bologna, Sant'Orsola-Malpighi Hospital, Bologna, Italy
| | - Giuseppe Guglielmi
- 4 Department of Radiology, University of Foggia, Foggia, Italy.,5 Department of Radiology, Scientific Institute "Casa Sollievo della Sofferenza" Hospital, Foggia, Italy
| | - Carlo Catalano
- 2 Department of Radiology, Sapienza University of Rome, Umberto I Hospital, Rome, Italy
| | - Ugo Albisinni
- 1 Diagnostic and Interventional Radiology, The "Rizzoli" Orthopaedic Institute, Bologna, Italy
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Evolution of Thermal Dosimetry for Application of Hyperthermia to Treat Cancer. ADVANCES IN HEAT TRANSFER 2015. [DOI: 10.1016/bs.aiht.2015.09.001] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
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